- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the... and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care… more
- Catholic Health (Buffalo, NY)
- …hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the people, carrying ... a liaison between front-end clinical areas and third-party payers in scenarios related to denials and appeals . This position educates all members of the patient… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …the general supervision of the Director of Patient Financial Services, the Clinical Appeals Specialist performs advanced level work related to clinical denial ... by conducting a comprehensive review of relevant clinical documentation. The Clinical Appeals Specialist will write compelling arguments based on clinical… more
- McLaren Health Care (Mount Clemens, MI)
- …responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and ... . Provides support to both internal and external customers for denial/ appeals activities and audits. Assists with monitoring and auditing activities, reviews… more
- Molina Healthcare (Columbus, OH)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers... appeals and denials . + Strong verbal and written communication skills To… more
- Hartford HealthCare (Farmington, CT)
- …**Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:** ... review of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials ,… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information...contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** +...Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and impact on revenue and trending. +… more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the ... pertaining to billing, coding, and documentation. The Inpatient Coding Denials Specialist will also handle audit-related and...appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation… more
- HCA Healthcare (Brentwood, TN)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Parallon you can be a part ... you need to succeed in our organization. We are looking for an enthusiastic Clinical Denials Coding Review Specialist to help us reach our goals. Unlock your… more
- UHS (Binghamton, NY)
- Position OverviewUnited Health Services (UHS) is seeking a proactive and analytical Clinical Denials Specialist to join our Revenue Cycle team. In this vital ... you will focus on the prevention and resolution of clinical claim denials by analyzing denial patterns, investigating and appealing denied claims, and collaborating… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Medical Billing & Denials Specialist Department: Patient Financial ServicesLocation: Massena HospitalHours Per Week: 40Schedule: Monday - Friday ... 8AM-4PM SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the...fee schedules, DRGs, and reimbursement procedures. + Claims and Appeals Processing: Submits and follows up on insurance claims;… more
- Community Health Systems (Franklin, TN)
- …the denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education ... of work products by the Coordinator and/or Director, Coding Denials and Appeals . + Partners with peers...RN, MD, PA, or DO preferred + CCS-Certified Coding Specialist required or + RHIT - Registered Health Information… more
- Johns Hopkins University (Middle River, MD)
- …issues and facilitate prompt payment of claims. Communicates with providers regarding appeals and medical policy denials and provides appropriate proactive ... We are seeking an **_AR Revenue Cycle Specialist III_** who will be responsible for the...specialized, complex or high-cost procedures. + Contacts providers regarding appeals and medical policy denials , identifies and… more
- Mount Sinai Health System (New York, NY)
- …Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status of Medical Record requests for denials to insure that ... **Job Description** **Insurance Specialist MSH PT Days 4/Days Week (Days Vary)...to perform clinical/technical/service/administrative tasks: + Prioritizes Insurance Requests / Denials when received in the department as per protocol… more
- Johns Hopkins University (Baltimore, MD)
- …payments. The Specialist will research and interpret medical policies regarding denials based on medical necessity. Will use a working knowledge of local ... We are seeking a **_AR Revenue Cycle Specialist II_** who will be responsible for the...+ Resolves claim edits. + Drafts and resolves non-standard appeals . + Researches medical policies to resolve denials… more
- Beth Israel Lahey Health (Burlington, MA)
- …15. Assists the Billing Supervisor with the resolution of complex claims issues, denials and appeals . 16. Completes projects and research as assigned. 17. ... Identifies, reviews, and interprets third party payments, adjustments and coding denials for all professional services. Reviews provider documentation in order to… more
- Robert Half Accountemps (Stony Brook, NY)
- …cycle Revenue Specialist involved in all aspects of medical billing, coding, appeals , denials , and claims. Willing to train but prefer a certification in ... Description We are looking for a dedicated Medical Billing Specialist to join our team! This position offers an...and payment reconciliation. * Investigate and resolve claim rejections, denials , and appeals with insurance companies to… more
- Robert Half Accountemps (Devens, MA)
- …play a vital part in ensuring accurate and timely billing processes while addressing appeals and denials . This position offers an opportunity to contribute to a ... Description We are looking for a detail-oriented Medical Billing Specialist to join our team on a contract basis...billing tasks, including claims processing and submissions. * Manage appeals and denials to ensure proper resolution… more